Utilization of the modified Kama scoring system for predicting bail-out cholecystectomy: a valuable tool in the era of rising laparoscopic surgery prevalence

Purpose Recently, bail-out cholecystectomy (BOC) during laparoscopic cholecystectomy to avoid severe complications, such as vasculobiliary injury, has become widely used and increased in prevalence. However, current predictive factors or scoring systems are insufficient. Therefore, in this study, we aimed to test the validity of existing scoring systems and determine a suitable cutoff value for predicting BOC. Methods We retrospectively assessed 305 patients who underwent laparoscopic cholecystectomy and divided them into a total cholecystectomy group ( n = 265) and a BOC group ( n = 40). Preoperative and operative findings were collected, and cutoff values for the existing scoring systems (Kama’s and Nassar’s) were modified using a prospectively maintained database. Results The BOC rate was 13% with no severe complications. A logistic regression analysis revealed that the Kama’s score (odds ratio, 0.93; 95% confidence interval 0.91–0.96; P